Thursday, January 1, 2009

I'd like to say that I lived the high life when I celebrated New Years in Johannesburg. Unfortunately, I'm not one for big celebrations and I was in bed by 9.30pm.We left Cape Town and arrived at Jo'Burg airport to be met by a tour group leader who took us out to a fabulous elephant sanctuary, just outside the city. It was a wonderful experience getting up close to the animals, feeling their leathery skin and muscular trunk. They were so docile and gentle despite being enormous in size. They were rescued elephants who are being rehabilitated and the sanctuary is doing amazing work.We came back to our hotel and we had high hopes of having a nice dinner to see in the New Year. Unfortunately, the restaurants nearby were all closed and we were left with the prospect of having a very subdued New Years. This did not bother me in the slighest, but it bothered my sister Rachel. There was no way she was going to sit in a hotel room, so she madly searched the internet trying to find somewhere to celebrate. She found a very large casino nearby and decided that we should take our chances by just turning up to see if any of the restaurants had a table. After the previous nights episode of tears, I knew that going to a large place, with large crowds and unpredictable plans was definitely not a good option for me so I told them I was staying behind. I think this upset my Mum somewhat, but I was defiant and they ended up going without me. I had a vegetable soup from room service, read my book and feel asleep long before midnight. I know many of you will think this a rather depressing way to celebrate New Years in a big city, but it was how I wanted to spend my time. I'm not the girl I used to be and it's going to take some time before I can get into the social scene again (was I ever really on the social scene??)This morning we did a guided tour of Soweto. I have recently finished Nelson Mandela's "A long Walk to Freedom" so my memory was fresh with the stories of apartheid and the ANC etc. I have to admit, I was a little disappointed with the experience. Nelson's house was boarded up as it is being converted into a museum and I couldn't see Desmond Tutu's house as it was behind a large cement wall. The surrounding houses were certainly not flash, but certainly did not display the poverty that was typical of Swaziland.In the afternoon, Mum, Graeme and Rachel went to a lion park whilst I joined my friend Niel. You may remember that Niel was the paramedic I "worked" with in Bulembu during my volunteer time there. He offered to take me out on an ambulance shift and I jumped at the opportunity to have a first hand experience at treating patients in one of the world's biggest trauma cities.It certainly was fascinating and I will elaborate more to my emergency medicine colleagues when I get home, but for those of you who are interested, let me just say, it was an eye opener.For our first call out, we were going to a patient who had been the recipient of "mob justice". This is where the local community decides to take the law into their own hands and issue their own form of punishment. This patient had being stabbed to the head and douced in petrol. We arrived before he was set alight. Getting to the scene was an adventure in itself. At one stage, we were travelling at 180km/hr and I was terrified. I thought I would be returning to Australia in a coffin. Apparently there are other ambulance drivers that travel at speeds of up to 200km/hr and I was grateful that we were taking things "safely". The patient was fine (we had police and fire department as an escort into the community as apparently the people can become violent against the paramedics). He kept commenting that he thought "the white girl was really pretty" (ie. me), but he was soon speechless when Niel told him sternly (in Zulu) that if he made any moves, he'd cut his testicles off. I was touched to be so well looked after....We were on our way to a second case when I looked at an overpass above the freeway and saw a man hanging over the side. He was attempting suicide and we stopped to see what we could do. As we were running to the scene, Niel asked me "Mel have you ever talked anyone down from a situation like this?". The answer, "Never" and I had no idea what I would say when I got up there. Thankfully, two local men had reached over the side and brought the man up for us. We soon found out that last night, the patient's parents had both been murdered in an armed robbery. They owned a butchery that was randomly targeted last night. After a very long discussion, we handed the man over to mental health services and went on to our next call.This time it was a major car accident. A combi carry 18 passengers and being driven by a 17 year old unlicensed driver had rolled and there were 18 casualties. I had absolutely no intention of doing an medical work, I was purely there to observe, but when I saw so many casualities, I got involved. I treated the driver who had significant burns and lacerations as well as a closed head injury. I rode in the back of the ambulance to the hospital with him. The ambulance was not equipped at all to deal with paramedics and there was no where for me to sit. We were travelling at ridiculous speeds and being thrown around the cabin. In the meantime, Niel and I were trying to get IV access, using sharps on a patient who may have had HIV. I had blood all over my hands and arms and I have to say, for the first time since I have been in Africa, I started to feel nervous. We made it to the hospital without event and I arrived to what Niel described as the "Baghdad of Johanessburg". It really was madness and I have no idea how the poor people of this country survive any trauma. There was no resuscitation team, in fact, no doctor and the nurse didn't seem too interested at all. Other patients were alongside us, unconscious, unstable and still waiting to see a doctor. My immediate instinct was to just jump in and start treating, but I realised I was unregistered and unable to provide any assistance (legally). It was all so surreal. For a country that appears to be a first world country, it certainly does not offer a first world health service. We also saw other stabbing injuries, but nothing too exciting to write about.Tonight, Niel, his girlfriend and I join my family for dinner and now we are about to go to bed for my last night in Africa. We are spending tomorrow at a Cheetah park before we fly out in the evening. Can you believe my adventure has ended so quickly? My next entry should be from the comfort of my parents home in Australia.

About Me

I am off again to practice medicine in the developing world. I'm replacing mountains with sand and sea and HIV with typhoid and leptospirosis. I'm now a little bit older and hopefully a lot more wiser.....